Insecure attachment has been described as mediating the relationship between childhood trauma and dysfunctional personality traits in different mental disorders. Despite the role insecure attachment and childhood trauma have independently demonstrated to play as determinants of borderline personality disorder, less is known about the mediating mechanisms explaining these associations. For the first time, we assessed adult attachment, childhood trauma and dimensional personality pathology in a sample of outpatients with borderline personality disorder and tested whether the association between childhood trauma and personality dysfunction was at least partially attributable to insecure attachment. The results showed that attachment anxiety fully mediated the relationship between specific types of trauma (emotional abuse and physical neglect) and emotional dysregulation. Further, emotional abuse was both directly associated with dissocial behaviour and indirectly via attachment anxiety (partial mediation). Emotional abuse has been described as an essential environmental factor for the development of borderline personality disorder and emotional dysregulation, on its part, as the core feature of the condition. Our results indicate that attachment anxiety explains the link between these central aspects of borderline personality disorder. Our findings are consistent with previous research and current etiological understanding of the condition and provide support for recommending a careful assessment of childhood traumatic experiences and adult attachment style to gain a more comprehensive insight into the symptoms and its heterogeneity. As a secondary aim, we assessed the effect parental mental illness may have in these mediation models, but no significant influence on childhood trauma, attachment or personality was found.

中文翻译：

---

依恋焦虑在边缘型人格障碍儿童创伤与人格障碍之间的中介作用

不安全依恋被描述为在不同精神障碍中调节童年创伤与功能失调人格特征之间的关系。尽管不安全依恋和童年创伤已独立证明是边缘型人格障碍的决定因素，但人们对解释这些关联的中介机制知之甚少。我们首次在边缘性人格障碍门诊患者样本中评估了成人依恋、童年创伤和维度人格病理学，并测试了童年创伤与人格障碍之间的关联是否至少部分归因于不安全依恋。结果表明，依恋焦虑完全介导了特定类型的创伤（情绪虐待和身体忽视）与情绪失调之间的关系。此外，情感虐待与非社交行为直接相关，并通过依恋焦虑（部分调解）间接相关。情绪虐待被描述为边缘型人格障碍和情绪失调发展的重要环境因素，就其本身而言，是该病症的核心特征。我们的研究结果表明，依恋焦虑解释了边缘型人格障碍的这些核心方面之间的联系。我们的研究结果与之前的研究和目前对该病的病因学理解一致，并为建议对童年创伤经历和成人依恋风格进行仔细评估以更全面地了解症状及其异质性提供支持。作为次要目标，我们评估了父母精神疾病在这些中介模型中可能产生的影响，但没有发现对童年创伤、依恋或人格的显着影响。